CommercialPrior AuthMedium impact
[New York] Precertification/prior authorization list change notification
Anthem BCBS·NY · Ophthalmology, Optometry, Pediatrics·Provider Bulletin
Effective date
Jan 1, 2027
We identified it
Sep 10, 2026
Summary
Anthem Blue Cross and Blue Shield is adding five CPT codes and one HCPCS code related to Dichoptic Digital Therapy for Amblyopia to their prior authorization requirements, effective January 1, 2027. All services using codes 0687T, 0688T, 0704T, 0705T, 0706T, and A9292 will now require precertification before service delivery to ensure coverage eligibility and compliance with clinical guidelines.
Action Required
By December 31, 2026: Billing team and providers must update clinical workflows and billing system configurations to require prior authorization for CPT codes 0687T, 0688T, 0704T, 0705T, 0706T, and HCPCS code A9292 for all Anthem Blue Cross and Blue Shield Commercial members in New York. Update encounter templates and clinical documentation tools to prompt providers to obtain precertification before scheduling or delivering Dichoptic Digital Therapy for Amblyopia services. Train front desk and authorization staff on the new requirement. Implement system rules to flag claims submitted without prior authorization approval. Failure to obtain required prior authorization will result in claim denials and potential patient billing liability.